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1. The Possible Impact of Aortic Stiffness on Quality of Late Life: An Exploratory Study

Author

Tap L, Dommershuijsen LJ, Corsonello A, Lattanzio F, Bustacchini S, Ziere G, van Saase JLCM, and Mattace-Raso FUS

Subjects
arterial stiffness, health-related quality of life, eq-5d, older persons, Geriatrics, RC952-954.6
Abstract

Lisanne Tap,1 Lisanne J Dommershuijsen,1 Andrea Corsonello,2 Fabrizia Lattanzio,2 Silvia Bustacchini,2 Gijsbertus Ziere,1 Jan LCM van Saase,3 Francesco US Mattace-Raso1 1Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; 2Italian National Research Center on Aging (INRCA), Ancona, Fermo and Cosenza, Italy; 3Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the NetherlandsCorrespondence: Francesco US Mattace-RasoSection Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Room Rg-527, PO BOX 2040, Rotterdam 3000 CA, the NetherlandsTel +31 10703 5979Fax +31 10703 47 68Email f.mattaceraso@erasmusmc.nlPurpose: Aortic stiffness (AS) is associated with cardiovascular events and all-cause mortality in the older population. AS might also influence the health-related quality of life (HRQOL) as a result of the negative effects of AS on cognitive and physical morbidity. We aimed to investigate the possible association between AS and HRQOL in people aged 75 years and over.Patients and Methods: This cross-sectional study was part of the SCOPE study, an international multicenter cohort observational study. The indicators for AS were aortic pulse wave velocity (aPWV) and central pulse pressure (cPP). HRQOL was assessed using the EQ-5D index and the EQ-5D visual analog scale (VAS). ANCOVA and multivariate regression models were used to investigate possible associations.Results: We included 280 Dutch participants of the SCOPE study. Median age was 79 years (IQR 76– 83) and 42.1% were women. Participants reporting any problem on the EQ-5D index (n=214) had higher values of aPWV (12.6 vs 12.2 m/s, p = 0.024) than participants not experiencing any problem (n=66) and comparable values of cPP (44.4 vs 42.0 mmHg, p = 0.119). Estimates only slightly changed after adjustments. No association was found between indicators of AS and EQ-5D VAS.Conclusion: Aortic stiffness was associated with impaired quality of late life. This association could be mediated by subclinical vascular pathology affecting mental and physical health.Keywords: arterial stiffness, health-related quality of life, EQ-5D, older persons

Published
2020

3. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans

Author

Jyvakorpi S. K., Ramel A., Strandberg T. E., Piotrowicz K., Blaszczyk-Bebenek E., Urtamo A., Rempe H. M., Geirsdottir O., Vagnerova T., Billot M., Larreur A., Savera G., Soriano G., Picauron C., Tagliaferri S., Sanchez-Puelles C., Cadenas V. S., Perl A., Tirrel L., Ohman H., Weling-Scheepers C., Ambrosi S., Costantini A., Pavelkova K., Klimkova M., Freiberger E., Jonsson P. V., Marzetti E., Pitkala K. H., Landi F., Calvani R., Bernabei R., Boni C., Brandi V., Broccatelli M., Celesti C., Cicchetti A., Collamati A., Coretti S., D'Angelo E., D'Elia M., Landi G., Lorenzi M., Mariotti L., Martone A. M., Ortolani E., Pafundi T., Picca A., Ruggeri M., Salini S., Tosato M., Vetrano D. L., Lattanzio F., Baldoni R., Bernabei S., Bonfigli A. R., Bustacchini S., Carrieri B., Cassetta L., Cherubini A., Cucchi M., Cucchieri G., Costantini A. R., Dell'Aquila G., Espinosa E., Fedecostante M., Fraternali R., Galeazzi R., Mengarelli A., Piomboni S., Posacki E., Severini E., Tregambe T., Trotta F., Maggio M., Lauretani F., Butto V., Fisichella A., Guareschi C., Longobucco Y., Di Bari M., Rodriguez-Manas L., Alamo S., Bouzon C. A., Gonzales Turin J., Zafra O. L. L., Picazo A. L., Sepulveda L. P., SanchezSanchez J. L., Puelles C. S., Aragones M. V., CruzJentoft A. J., Santos J. A., Alvarez-Nebreda L., JimenezJimenez N. F., Nozal J. M. -D., Montero-Errasquin B., Moreno B. P. B. P., Roldan-Plaza C., Vicente A. R. -D., Sanchez-Cadenas V., Sanchez-Castellano C., Sanchez-Garcia E., Vaquero-Pinto M. N., Topinkova E., Bautzka L., Blechova K., Gueye T., Juklickova I., Klbikova T., Krenkova J. J., Madlova P., Mejstrikova H., Melcova R., Michalkova H., Ryznarova I., Drastichova I., Hasalikova E., Hucko R., Jakub S., Janacova M., Kilmkova M., Parizkova M., Redrova M., Ruskova P. P., Sieber C. C., Auerswald T., Engel C., Franke A., Freibergen E., Freiheit U., Gotthardt S., Kampe K., Kob R., Kokott C., Kraska C., Meyer C., Reith V., Rempe H., Schoene D., Sieber G., Zielinski K., Anker S. D., Ebner N., Grutz R., von Haehling S., Schols A. M. W. J., Gosker H., Huysmans S., Quaaden S., Schols J. M., Smeets N., Stevens P., van de Bool C., Weling C., Strandberg T., Jyvakorpi S., Hallikas K., Herranen M., Huusko T., Hytonen L., Ikonen K., Karppi-Sjoblom A., Karvinen K., Kayhty M., Kindsted T., Landstrom E., Leirimaa S., Pitkala K., Punkka A., Saavalainen A. -M., Salo T., Sepa M., Sohlberg K., Vaatamoinen E., Venalainen S., Vanhanen H., Vellas B., Van Kan G. A., Biville V., Brigitte L., Cervera C., Cesari M., Champarnaud M., Cluzan C., Croizet M., Dardenne S., Dorard M., Dupuy C., Durand E., Faisant C., Fougere B., Girard P., Guyonnet S., Hoogendijk E., Mauroux R., Milhet A., Montel S., Ousset P. -J., Teguo M. T., Teysseyre B., Andrieu S., Blasimme A., Dray C., Rial-Sebbag E., Valet P., Dantoine T., Cardinaud N., Castelli M., Charenton-Blavignac M., Ciccolari-Micaldi C., Gayot C., Laubarie-Mouriet C., Marchesseau D., Mergans T., Nguyen T. B., Papon A., Ribet J., Saulinier I., Tchalla A., Rapp T., Sirven N., Skalska A., Blaszcyk E., Cwynar M., Czesak J., Fatyga P., Fedyk-Lukasik M., Grodzicki T., Jamrozik P., Janusz Z., Klimek E., Komoniewska S., Kret M., Ozog M., Parnicka A., Petitjean K., Pietrzyk A., Skalska-Dulinska B., Starzyk D., Szczerbinska K., Witkiewicz B., Wlodarczyk A., Sinclair A., Harris S., Ogborne A., Ritchie S., Sinclair C., Sinclair H., Bellary S., Worthington H., Derejczyk J., Roller-Wirnsberger R., Jonsson P., Bordes P., Arnaud S., Asbrand C., Bejuit R., Durand S., Flechsenhar K., Joly F., Lain R. L., Moncharmont M., Msihid J., Ndja A., Riche B., Weber A. C., Yuan J., Roubenoff R., Kortebein P., Miller R. R., Gorostiaga C., Belissa-Mathiot P., Hu H., Laigle L., Melchor I. M., Russel A., Bennecky M., Haws T., Joshi A., Philpott K., Walker A., Zia G., Giorgi S. D., Feletti L., Marchioro E., Mocci F., Varesio M. G., Cesario A., Cabin B., de Boer W. P., Ignaszewski C., Klingmann I., Vollenbroek-Hutten M., Hermens T., Jansen-Kosterink S., Tabak M., Blandin P., Coutard L., Lenzotti A. -M., Mokhtari H., Rodon N., RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Clinicum, Department of General Practice and Primary Health Care, University of Helsinki, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Helsinki University Hospital Area, Teachers' Academy, Jyvakorpi S.K., Ramel A., Strandberg T.E., Piotrowicz K., Blaszczyk-Bebenek E., Urtamo A., Rempe H.M., Geirsdottir O., Vagnerova T., Billot M., Larreur A., Savera G., Soriano G., Picauron C., Tagliaferri S., Sanchez-Puelles C., Cadenas V.S., Perl A., Tirrel L., Ohman H., Weling-Scheepers C., Ambrosi S., Costantini A., Pavelkova K., Klimkova M., Freiberger E., Jonsson P.V., Marzetti E., Pitkala K.H., Landi F., Calvani R., Bernabei R., Boni C., Brandi V., Broccatelli M., Celesti C., Cicchetti A., Collamati A., Coretti S., D'Angelo E., D'Elia M., Landi G., Lorenzi M., Mariotti L., Martone A.M., Ortolani E., Pafundi T., Picca A., Ruggeri M., Salini S., Tosato M., Vetrano D.L., Lattanzio F., Baldoni R., Bernabei S., Bonfigli A.R., Bustacchini S., Carrieri B., Cassetta L., Cherubini A., Cucchi M., Cucchieri G., Costantini A.R., Dell'Aquila G., Espinosa E., Fedecostante M., Fraternali R., Galeazzi R., Mengarelli A., Piomboni S., Posacki E., Severini E., Tregambe T., Trotta F., Maggio M., Lauretani F., Butto V., Fisichella A., Guareschi C., Longobucco Y., Di Bari M., Rodriguez-Manas L., Alamo S., Bouzon C.A., Gonzales Turin J., Zafra O.L.L., Picazo A.L., Sepulveda L.P., SanchezSanchez J.L., Puelles C.S., Aragones M.V., CruzJentoft A.J., Santos J.A., Alvarez-Nebreda L., JimenezJimenez N.F., Nozal J.M.-D., Montero-Errasquin B., Moreno B.P.B.P., Roldan-Plaza C., Vicente A.R.-D., Sanchez-Cadenas V., Sanchez-Castellano C., Sanchez-Garcia E., Vaquero-Pinto M.N., Topinkova E., Bautzka L., Blechova K., Gueye T., Juklickova I., Klbikova T., Krenkova J.J., Madlova P., Mejstrikova H., Melcova R., Michalkova H., Ryznarova I., Drastichova I., Hasalikova E., Hucko R., Jakub S., Janacova M., Kilmkova M., Parizkova M., Redrova M., Ruskova P.P., Sieber C.C., Auerswald T., Engel C., Franke A., Freibergen E., Freiheit U., Gotthardt S., Kampe K., Kob R., Kokott C., Kraska C., Meyer C., Reith V., Rempe H., Schoene D., Sieber G., Zielinski K., Anker S.D., Ebner N., Grutz R., von Haehling S., Schols A.M.W.J., Gosker H., Huysmans S., Quaaden S., Schols J.M., Smeets N., Stevens P., van de Bool C., Weling C., Strandberg T., Jyvakorpi S., Hallikas K., Herranen M., Huusko T., Hytonen L., Ikonen K., Karppi-Sjoblom A., Karvinen K., Kayhty M., Kindsted T., Landstrom E., Leirimaa S., Pitkala K., Punkka A., Saavalainen A.-M., Salo T., Sepa M., Sohlberg K., Vaatamoinen E., Venalainen S., Vanhanen H., Vellas B., Van Kan G.A., Biville V., Brigitte L., Cervera C., Cesari M., Champarnaud M., Cluzan C., Croizet M., Dardenne S., Dorard M., Dupuy C., Durand E., Faisant C., Fougere B., Girard P., Guyonnet S., Hoogendijk E., Mauroux R., Milhet A., Montel S., Ousset P.-J., Teguo M.T., Teysseyre B., Andrieu S., Blasimme A., Dray C., Rial-Sebbag E., Valet P., Dantoine T., Cardinaud N., Castelli M., Charenton-Blavignac M., Ciccolari-Micaldi C., Gayot C., Laubarie-Mouriet C., Marchesseau D., Mergans T., Nguyen T.B., Papon A., Ribet J., Saulinier I., Tchalla A., Rapp T., Sirven N., Skalska A., Blaszcyk E., Cwynar M., Czesak J., Fatyga P., Fedyk-Lukasik M., Grodzicki T., Jamrozik P., Janusz Z., Klimek E., Komoniewska S., Kret M., Ozog M., Parnicka A., Petitjean K., Pietrzyk A., Skalska-Dulinska B., Starzyk D., Szczerbinska K., Witkiewicz B., Wlodarczyk A., Sinclair A., Harris S., Ogborne A., Ritchie S., Sinclair C., Sinclair H., Bellary S., Worthington H., Derejczyk J., Roller-Wirnsberger R., Jonsson P., Bordes P., Arnaud S., Asbrand C., Bejuit R., Durand S., Flechsenhar K., Joly F., Lain R.L., Moncharmont M., Msihid J., Ndja A., Riche B., Weber A.C., Yuan J., Roubenoff R., Kortebein P., Miller R.R., Gorostiaga C., Belissa-Mathiot P., Hu H., Laigle L., Melchor I.M., Russel A., Bennecky M., Haws T., Joshi A., Philpott K., Walker A., Zia G., Giorgi S.D., Feletti L., Marchioro E., Mocci F., Varesio M.G., Cesario A., Cabin B., de Boer W.P., Ignaszewski C., Klingmann I., Vollenbroek-Hutten M., Hermens T., Jansen-Kosterink S., Tabak M., Blandin P., Coutard L., Lenzotti A.-M., Mokhtari H., Rodon N., Epidemiology and Data Science, APH - Aging & Later Life, and APH - Quality of Care

Subjects
0301 basic medicine, Gerontology, Sarcopenia, [SDV]Life Sciences [q-bio], Population, PROTEIN, RECOMMENDATIONS, law.invention, SUPPLEMENTATION, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), Cultural diversity, medicine, Nutrition counselling, Nutrition intervention, Humans, 030212 general & internal medicine, Medical prescription, education, Exercise, Aged, 2. Zero hunger, education.field_of_study, 030109 nutrition & dietetics, Frailty, business.industry, Settore MED/09 - MEDICINA INTERNA, ADULTS, medicine.disease, mobility, 3. Good health, Feasibility Studie, Malnutrition, SPRINTT, resistance exercise, muscle mass, Protein intake, 3121 General medicine, internal medicine and other clinical medicine, Feasibility Studies, Energy intake, Independent Living, business, Nutrition counseling, Research Paper, Human
Abstract

Aim To describe the methods and feasibility of the nutritional intervention carried out within the SPRINTT Randomized cotrolled trial. We also illustrate how nutrition interventionists identified participants at risk of malnutrition and the lessons learnt from the nutrition intervention. Findings SPRINTT nutrition intervention was well-received by the majority of the participants. It was mainly carried out using tailored nutrition counselling, but also other means of delivering the intervention were successfully used. Compared with a standard nutrition prescription, an individualized protocol to diagnose malnutrition and follow-up by tailored nutrition counselling helped achieve nutritional targets more effectively in spite of diversity of population in nutritional habits and in some cases reluctance to accept changes. Message The SPRINTT nutrition intervention was feasible and allowed flexibility to the varying needs and cultural differences of this heterogeneous population of frail, older Europeans. It may serve as a model to educate and improve nutrition among community-dwelling older people at risk of mobility limitations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-020-00438-4., Background The “Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies” (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3–9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0–1.2 g/kg body weight, energy intake of 25–30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-020-00438-4.

Published
2021

4. The possible impact of aortic stiffness on quality of late life: An exploratory study

Author

Tap, L. (Lisanne), Dommershuijsen, L.J. (Lisanne J.), Corsonello, A. (Andrea), Lattanzio, F. (Fabrizia), Bustacchini, S. (Silvia), Ziere, G. (Gijsbertus), Saase, J.L.C.M. (Jan) van, Mattace Raso, F.U.S. (Francesco), Tap, L. (Lisanne), Dommershuijsen, L.J. (Lisanne J.), Corsonello, A. (Andrea), Lattanzio, F. (Fabrizia), Bustacchini, S. (Silvia), Ziere, G. (Gijsbertus), Saase, J.L.C.M. (Jan) van, and Mattace Raso, F.U.S. (Francesco)

Abstract

Purpose: Aortic stiffness (AS) is associated with cardiovascular events and all-cause mortality in the older population. AS might also influence the health-related quality of life (HRQOL) as a result of the negative effects of AS on cognitive and physical morbidity. We aimed to investigate the possible association between AS and HRQOL in people aged 75 years and over. Patients and Methods: This cross-sectional study was part of the SCOPE study, an international multicenter cohort observational study. The indicators for AS were aortic pulse wave velocity (aPWV) and central pulse pressure (cPP). HRQOL was assessed using the EQ-5D index and the EQ-5D visual analog scale (VAS). ANCOVA and multivariate regression models were used to investigate possible associations. Results: We included 280 Dutch participants of the SCOPE study. Median age was 79 years (IQR 76–83) and 42.1% were women. Participants reporting any problem on the EQ-5D index (n=214) had higher values of aPWV (12.6 vs 12.2 m/s, p = 0.024) than participants not experiencing any problem (n=66) and comparable values of cPP (44.4 vs 42.0 mmHg, p = 0.119). Estimates only slightly changed after adjustments. No association was found between indicators of AS and EQ-5D VAS. Conclusion: Aortic stiffness was associated with impaired quality of late life. This association could be mediated by subclinical vascular pathology affecting mental and physical health.

Published
2020
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5. Design and methodology of the screening for CKD among older patients across Europe (SCOPE) study: A multicenter cohort observational study

Author

Corsonello, A. (Andrea), Tap, L. (Lisanne), Roller-Wirnsberger, R. (Regina), Wirnsberger, G. (Gerhard), Zoccali, C. (Carmine), Kostka, T. (Tomasz), Guligowska, A. (Agnieszka), Mattace Raso, F.U.S. (Francesco), Gil, P. (Pedro), Fuentes, L.G. (Lara Guardado), Meltzer, I. (Itshak), Yehoshua, I. (Ilan), Formiga-Perez, F. (Francesc), Moreno-González, R. (Rafael), Weingart, C. (Christian), Freiberger, E. (Ellen), Ärnlöv, J. (Johan), Carlsson, A.C. (Axel C.), Bustacchini, S. (Silvia), Lattanzio, F. (Fabrizia), Bolognini, S. (Silvia), D'Ascoli, P. (Paola), Moresi, R. (Raffaella), Di Stefano, G. (Giuseppina), Cassetta, L. (Laura), Bonfigli, A.R. (Anna Rita), Galeazzi, R. (Roberta), Lenci, F. (Federica), Bella, S.D. (Stefano Della), Bordoni, E. (Enrico), Provinciali, M. (Mauro), Giacconi, R. (Robertina), Giuli, C. (Cinzia), Postacchini, D. (Demetrio), Garasto, S. (Sabrina), Firmani, A.C.R. (Annalisa Cozza Romano), Nacciariti, M. (Moreno), Di Rosa, M. (Mirko), Bernabei, P.F.R. (Paolo Fabbietti Roberto), Bula, C. (Christophe), Haller, H. (Hermann), Jager, K.J. (Kitty), Biesen, W. (Wim) van, Stevens, P.E. (Paul E.), Corsonello, A. (Andrea), Tap, L. (Lisanne), Roller-Wirnsberger, R. (Regina), Wirnsberger, G. (Gerhard), Zoccali, C. (Carmine), Kostka, T. (Tomasz), Guligowska, A. (Agnieszka), Mattace Raso, F.U.S. (Francesco), Gil, P. (Pedro), Fuentes, L.G. (Lara Guardado), Meltzer, I. (Itshak), Yehoshua, I. (Ilan), Formiga-Perez, F. (Francesc), Moreno-González, R. (Rafael), Weingart, C. (Christian), Freiberger, E. (Ellen), Ärnlöv, J. (Johan), Carlsson, A.C. (Axel C.), Bustacchini, S. (Silvia), Lattanzio, F. (Fabrizia), Bolognini, S. (Silvia), D'Ascoli, P. (Paola), Moresi, R. (Raffaella), Di Stefano, G. (Giuseppina), Cassetta, L. (Laura), Bonfigli, A.R. (Anna Rita), Galeazzi, R. (Roberta), Lenci, F. (Federica), Bella, S.D. (Stefano Della), Bordoni, E. (Enrico), Provinciali, M. (Mauro), Giacconi, R. (Robertina), Giuli, C. (Cinzia), Postacchini, D. (Demetrio), Garasto, S. (Sabrina), Firmani, A.C.R. (Annalisa Cozza Romano), Nacciariti, M. (Moreno), Di Rosa, M. (Mirko), Bernabei, P.F.R. (Paolo Fabbietti Roberto), Bula, C. (Christophe), Haller, H. (Hermann), Jager, K.J. (Kitty), Biesen, W. (Wim) van, and Stevens, P.E. (Paul E.)

Abstract

Background: Decline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align l

Published
2018
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6. Design and methodology of the screening for CKD among older patients across Europe (SCOPE) study: a multicenter cohort observational study

Author

Corsonello, A, Tap, Lisanne, Roller-Wirnsberger, R, Wirnsberger, G, Zoccali, C, Kostka, T, Guligowska, A, Mattace Raso, F.U.S., Gil, P, Fuentes, LG, Meltzer, I, Yehoshua, I, Formiga-Perez, F, Moreno-Gonzalez, R, Weingart, C, Freiberger, E, Arnlov, J, Carlsson, AC, Bustacchini, S, Lattanzio, F, Corsonello, A, Tap, Lisanne, Roller-Wirnsberger, R, Wirnsberger, G, Zoccali, C, Kostka, T, Guligowska, A, Mattace Raso, F.U.S., Gil, P, Fuentes, LG, Meltzer, I, Yehoshua, I, Formiga-Perez, F, Moreno-Gonzalez, R, Weingart, C, Freiberger, E, Arnlov, J, Carlsson, AC, Bustacchini, S, and Lattanzio, F

Published
2018

7. The economic burden of inappropriate drug prescribing, lack of adherence and compliance, adverse drug events in older people: a systematic review

Author

Chiatti, C, Bustacchini, S, Furneri, G, Mantovani, L, Cristiani, M, Misuraca, C, Lattanzio, F, Chiatti C, Bustacchini S, Furneri G, Mantovani L, Cristiani M, Misuraca C, Lattanzio f, Chiatti, C, Bustacchini, S, Furneri, G, Mantovani, L, Cristiani, M, Misuraca, C, Lattanzio, F, Chiatti C, Bustacchini S, Furneri G, Mantovani L, Cristiani M, Misuraca C, and Lattanzio f

Abstract

Adverse drug events (ADEs) are an increasingly relevant issue for healthcare systems as they are associated with poorer health outcomes and avoidable misuse of resources. The rates of ADEs are higher in the elderly population, as many older patients have comorbidities, multiple drug prescriptions and deteriorated physical and cognitive functioning. The occurrence of ADEs can lead to a perceived lack of therapy efficacy and further underuse or suboptimal adherence in elderly people, with detrimental clinical outcomes. The present article systematically reviews the studies evaluating the economic impact of ADEs occurring as consequence of poor therapy adherence, inappropriate drug use, underuse of effective treatments and poor adherence, medication errors, drug-drug and drug-disease interactions. A Medline systematic literature review of studies evaluating the economic consequences of inappropriate drug prescribing, lack of adherence and compliance, ADEs in older people was performed. English-language articles were screened through a three-step approach (title review, abstract review, full article review) to select pertinent studies quantitatively evaluating costs. We systematically reviewed evidence from767 articles. After title, abstract and full text review, 21 articles were found to measure economic implications ofADEs, inappropriate drug prescribing and poor adherence in elderly patients. Studies suggested that the economic impact of these undesired effects is substantial: hospital costs were the main cost driver, with a relevant part of them being preventable (consequences of inappropriate prescribing). Healthcare costs for unused drug wastage and destruction were also surprisingly high. Although economic evidence in elderly patients is still limited, all studies seemed to confirm that the financial burden due to pharmacological treatment issues is relevant in elderly people. Including economic effects of adverse events in pharmacoeconomic analysis would be bene

Published
2012

8. The economic impact of moderate stage Alzheimer's disease in Italy: Evidence from the UP-TECH randomized trial

Author

Chiatti, C., Furneri, G., Rimland, J. M., Demma, F., Bonfranceschi, F., Cassetta, L., Masera, F. b, Cherubini, Corsonello, A., Lattanzio, F., Baldassarri, D., Bitti, L., Carosi, A., Sabbatini, M., Paolasini, E., Fiori, T., Fronzi, C., Giacchetta, S., Giacomini, V., Giovagnoli, L., Lattanzi, G., Manca, A. M., Marinelli, I., Pigini, V., Pignotti, M., Proietti, M. C., Quarticelli, A., Rovedi, M., Tasso, L., Valeri, V., Antonioli, A., Barabucci, M., Bassani, M., Bollettini, P., Bruttapasta, M. C., Buccolini, C., Carangella, R., Carboni, F., Ceccolini, D., D'Incecco, P., Di Felice, M., Dini, L., Gioia, G., Di Prima, G., Giusepponi, G., Lanciotti, C., Loffreda, A., Luciani, O., Mariani, L., Mastrorilli, F., Moroni, R., Piatkowska, I., Rucoli, R., Scoccia, G., Teodori, N., Tonelli, T., Angeloni, R., Bratti, R. A., Bonafede, G., Lorenzetti, S., Paci, C., Picciotti, G., Pezzola, D., Rea, V., Scialè, V., Signorino, M., Sorvillo, F., Tomassini, P. F., Ciccola, A., Cionfrini, L., Alessandrini, D., De Santis, A., Formica, B., Tacchi, G., Tortorelli, S., Marchegiani, G., Pozzari, G., Santarelli, G., Bartolucci, D., Caraffa, G., Cavallo, Filippo, Di Furia, L., Lacetera, A., Maffei, C. M., Manzoli, L., Postacchini, D., Bevilacqua, R., Bonfigli, A. R., Bustacchini, S., Capasso, M., Civerchia, P., Di Rosa, M., Giuli, C., Marcellini, M., Marinelli, P., Melchiorre, G., Moraca, M. E., Principi, A., Rocchetti, C., Spazzafumo, L., Vincitorio, D., Bartulewicz, K., Olivetti, P., and Rossi, L.

Subjects
Gerontology, Male, very elderly, cost of illness, Public expenditure, morbidity, residential care, community care, Italian (citizen), cost analysis, Surveys and Questionnaires, Health care, Activities of Daily Living, 80 and over, Medicine, organization and management, caregiver, media_common, Aged, 80 and over, Public sector, Mini Mental State Examination, aged, Alzheimer disease, Article, controlled study, daily life activity, disease severity, economic aspect, female, health care, health care cost, human, Italy, major clinical study, mortality, physical performance, prescription, prevalence, randomized controlled trial, scoring system, social care, socioeconomics, welfare, economics, male, quality of life, questionnaire, statistical model, Activities of Daily Living, Aged, Alzheimer Disease, Caregivers, Cost of Illness, Female, Health Expenditures, Humans, Linear Models, Quality of Life, Alzheimer's disease, community-living, RCT, UP-TECH, Psychiatry and Mental health, Clinical Psychology, Alzheimer’s disease, media_common.quotation_subject, Quality of life (healthcare), Dementia, Medical prescription, Socioeconomic status, business.industry, statistical model, medicine.disease, Geriatrics and Gerontology, business, Welfare
Abstract

Background:There is consensus that dementia is the most burdensome disease for modern societies. Few cost-of-illness studies examined the complexity of Alzheimer's disease (AD) burden, considering at the same time health and social care, cash allowances, informal care, and out-of-pocket expenditure by families.Methods:This is a comprehensive cost-of-illness study based on the baseline data from a randomized controlled trial (UP-TECH) enrolling 438 patients with moderate AD and their primary caregiver living in the community.Results:The societal burden of AD, composed of public, patient, and informal care costs, was about €20,000/yr. Out of this, the cost borne by the public sector was €4,534/yr. The main driver of public cost was the national cash-for-care allowance (€2,324/yr), followed by drug prescriptions (€1,402/yr). Out-of-pocket expenditure predominantly concerned the cost of private care workers. The value of informal care peaked at €13,590/yr. Socioeconomic factors do not influence AD public cost, but do affect the level of out-of-pocket expenditure.Conclusion:The burden of AD reflects the structure of Italian welfare. The families predominantly manage AD patients. The public expenditure is mostly for drugs and cash-for-care benefits. From a State perspective in the short term, the advantage of these care arrangements is clear, compared to the cost of residential care. However, if caregivers are not adequately supported, savings may be soon offset by higher risk of caregiver morbidity and mortality produced by high burden and stress. The study has been registered on the website www.clinicaltrials.org (Trial Registration number: NCT01700556).

Published
2015

9. The economic burden of chronic obstructive pulmonary disease in the elderly: Results from a systematic review of the literature

Author

Bustacchini, S, Chiatti, C, Furneri, G, Lattanzio, F, Mantovani, L, Bustacchini S, Chiatti C, Furneri G, Lattanzio F, Mantovani LG, Bustacchini, S, Chiatti, C, Furneri, G, Lattanzio, F, Mantovani, L, Bustacchini S, Chiatti C, Furneri G, Lattanzio F, and Mantovani LG

Abstract

Purpose of review: Chronic obstructive pulmonary disease (COPD) is a high prevalence condition with a significant clinical and economic burden. In elderly people, COPD is often associated with other chronic comorbidities (i.e. cardiovascular diseases), determining clinical complications and requiring frequent acute healthcare interventions. The aim of this article is to review the economic studies evaluating costs and healthcare resource utilization in elderly (≥65 years) COPD patients. Recent findings: Sixteen of the initial 359 articles retrieved through our research strategy were found to include relevant cost information on elderly COPD patients or to evaluate the effect of older age on healthcare expenditure. Most studies were carried out in the United States and used administrative database claims to determine resource consumption and direct costs (attributable and not). Very few studies focused exclusively on elderly patients. Summary: Results showed a certain variability of cost estimations, mainly due to the different methodologies and adopted cost approach. However, we found a trend of direct cost growth in the elderly population, which can be explained by a more frequent use of acute healthcare services, especially for managing COPD exacerbations. These results cannot be considered definitive and new studies, targeting elderly people, are required in order to confirm these preliminary findings. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Published
2011

10. Management of hypertension and dyslipidemia in primary care in Italy

Author

Sturkenboom, M, Mazzaglia, G, Picelli, G, Mozaffari, E, Bustacchini, S, Kramarz, P, Filippi, A, Sturkenboom MC, Mazzaglia G, Picelli G, Mozaffari E, Bustacchini S, Kramarz P, Filippi A, Sturkenboom, M, Mazzaglia, G, Picelli, G, Mozaffari, E, Bustacchini, S, Kramarz, P, Filippi, A, Sturkenboom MC, Mazzaglia G, Picelli G, Mozaffari E, Bustacchini S, Kramarz P, and Filippi A

Abstract

Objectives: Guidelines for the screening, treatment, and monitoring of modifiable cardiovascular risk factors such as hypertension (HTN) and dyslipidemia (DYS), have been developed to assist physicians in lowering the global risk of cardiovascular disease (CVD). This study assessed the management of patients with these conditions in a primary care setting in Italy. Methods: This was a retrospective cohort study conducted in 2000–2002 using the Italian Health Search Database (HSD). The management of HTN (blood pressure [BP] 140/90 mmHg) and DYS (total cholesterol 5 mmol/L [193 mg/dL]) was assessed by measuring the numbers of patients screened for one or both conditions, the numbers treated pharmacologically, and the numbers monitored for treatment success. Management patterns were stratified by history of cardiovascular events. Results: Blood pressure screening at a population level was approximately 35% for HTN in each year whereas for DYS, it increased from 26% in 2000 to 32% in 2002. Over the study period, the prevalence of HTN increased from 19% to 23%, whereas the prevalence for DYS doubled (from 14% to 28%). For both HTN and DYS these prevalences were substantially lower than national survey estimates (23% versus 48% for HTN and 16% versus 57% for DYS in 2001). Among patients with newly identified HTN or DYS, eligible for reimbursed pharmacological treatment, 26% and 82%, respectively, were not treated within 1 year of diagnosis. Treatment levels were higher in patients with a history of CVD, but were still far from optimal. Monitoring of BP and cholesterol in the first year of treatment was sub-optimal e.g. 36% of newly-treated HTN patients had no record of a BP evaluation and 32% of newly-treated DYS patients had no record of a cholesterol assessment. Blood pressure monitoring was slightly higher in patients with a history of CVD. Extrapolation to all new HTN and DYS patients showed that less than 50% of patients with HTN and 12% of those with DYS were adequa

Published
2005

11. Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients: Evidence From the Up-Tech Study

Author

Barbabella, F., Chiatti, C., Rimland, J. M., Melchiorre, M. G., Lamura, G., Lattanzio, F., Baldassarri, D., Bitti, L., Carosi, A., Sabbatini, M., Paolasini, E., Fiori, T., Fronzi, C., Giacchetta, S., Giacomini, V., Giovagnoli, L., Lattanzi, G., Manca, A. M., Pigini, V., Pignotti, M., Proietti, M. C., Quarticelli, A., Rovedi, M., Tasso, L., Valeri, V., Antonioli, A., Barabucci, M., Bassani, M., Bollettini, P., Bruttapasta, M. C., Buccolini, C., Carangella, R., Carboni, F., Ceccolini, D., D'Incecco, P., Di Felice, M., Dini, L., Gioia, G., Di Prima, G., Giusepponi, G., Lanciotti, C., Loffreda, A., Luciani, O., Mariani, L., Mastrorilli, F., Moroni, R., Piatkowska, I., Rucoli, R., Scoccia, G., Teodori, N., Tonelli, T., Angeloni, R., Bratti, R. A., Bonafede, G., Lorenzetti, S., Paci, C., Picciotti, G., Pezzola, D., Rea, V., Scialè, V., Signorino, M., Sorvillo, F., Tomassini, P. F., Ciccola, A., Cionfrini, L., Alessandrini, D., De Santis, A., Formica, B., Tacchi, G., Tortorelli, S., Regional, M., Marchegiani, G., Pozzari, G., Santarelli, G., Bartolucci, D., Caraffa, G., Cavallo, Filippo, Di Furia, L., Lacetera, A., Maffei, C. M., Manzoli, L., Postacchini, D., Bonfigli, A. R., Bonfranceschi, F., Bustacchini, S., Capasso, M., Cassetta, L., Civerchia, P., Demma, F., Di Rosa, M., Furneri, G., Giuli, C., Marcellini, M., Marinelli, P., Melchiorre, G., Moraca, M. E., Principi, A., Rocchetti, C., Spazzafumo, L., Vincitorio, D., Bartulewicz, K., Olivetti, P., and Rossi, L.

Subjects
Gerontology, Migrant care worker, Male, Financing, Government, very elderly, aged, Alzheimer disease, caregiver, economics, educational status, employment, female, financial management, home care, human, Italy, long term care, male, middle aged, migration, socioeconomics, standards, statistics and numerical data, supply and distribution, very elderly, Aged, Aged, 80 and over, Alzheimer Disease, Caregivers, Educational Status, Employment, Female, Financing, Personal, Home Care Services, Humans, Long-Term Care, Middle Aged, Socioeconomic Factors, Transients and Migrants, Alzheimer's disease, Care allowance, Family caregiver, Socioeconomic factors, Up-Tech, Disease, 0302 clinical medicine, 050602 political science & public administration, 80 and over, 030212 general & internal medicine, Family caregivers, 05 social sciences, 0506 political science, Clinical Psychology, Government, population characteristics, Financing, geographic locations, Social Psychology, Social class, Financial management, 03 medical and health sciences, medicine, Personal, Socioeconomic status, Aged, business.industry, medicine.disease, Long-term care, Care workers, Geriatrics and Gerontology, business
Abstract

The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs.We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers).The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW.Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.

Published
2014

12. Management of Antihypertensive Drugs in Newly-Diagnosed Hypertensive Patients in Italy: A Retrospective Cohort Study in Primary Care

Author

Mazzaglia, G, Sturkenboom, M, Ruffo, P, Mantovani, L, Bustacchini, S, Filippi, A, Brignoli, O, Caputi, A, Mazzaglia G, Sturkenboom MC, Ruffo P, Mantovani L, Bustacchini S, Filippi A, Brignoli O, Caputi AP, Mazzaglia, G, Sturkenboom, M, Ruffo, P, Mantovani, L, Bustacchini, S, Filippi, A, Brignoli, O, Caputi, A, Mazzaglia G, Sturkenboom MC, Ruffo P, Mantovani L, Bustacchini S, Filippi A, Brignoli O, and Caputi AP

Published
2004

13. Estimating renal function to reduce the risk of adverse drug reactions

Author

Corsonello, A, Onder, Graziano, Bustacchini, S, Provinciali, M, Garasto, S, Gareri, P, Lattanzio, F., Onder, Graziano (ORCID:0000-0003-3400-4491), Corsonello, A, Onder, Graziano, Bustacchini, S, Provinciali, M, Garasto, S, Gareri, P, Lattanzio, F., and Onder, Graziano (ORCID:0000-0003-3400-4491)

Abstract

The aging process is characterized by relevant changes in pharmacokinetics. Renal function is known to decline with aging. However, as a result of reduced muscle mass, older individuals frequently have a depressed glomerular filtration rate (GFR) despite normal serum creatinine, and such a concealed renal insufficiency may impact significantly on the clearance of hydrosoluble drugs, as well as the risk of adverse drug reactions (ADRs) from hydrosoluble drugs. The assessment of renal function should thus be a mandatory item in the global examination of patient characteristics. Equations for estimating GFR have become very popular in recent years. However, different equations may yield significantly different estimated glomerular filtration rate (eGFR) values, which have important implications in dosing drugs cleared by the kidney. Current knowledge suggests that eGFR based on the Chronic Kidney Disease-Epidemiological Collaboration (CKD-EPI) study equation outperformed eGFR based on the Modification of Diet in Renal Disease (MDRD) study equation and creatinine clearance estimate based on the Cockcroft-Gault formula as a predictor of ADRs from kidney cleared drugs. More recently, the combined creatinine-cystatin C equation was shown to perform better than equations based on either of these markers alone in diagnosing CKD, even in older patients. However, its accuracy in predicting ADRs and usefulness in drug dosing is still to be investigated.

Published
2012

23. Cu to Zn ratio, physical function, disability, and mortality risk in older elderly (ilSIRENTE study)

Author

Silvia Giovannini, Silvia Bustacchini, Ettore Capoluongo, Fabrizia Lattanzio, Francesco Piacenza, Roberto Bernabei, Marco Malavolta, Enrico Guffanti, Eugenio Mocchegiani, Andrea Russo, Andrea Basso, Angela Marie Abbatecola, Francesco Landi, Mocchegiani, E, Malavolta, M, Lattanzio, F, Piacenza, F, Basso, A, Abbatecola, Am, Russo, A, Giovannini, S, Capoluongo, E, Bustacchini, S, Guffanti, Ee, Bernabei, R, and Landi, F

Subjects
Male, Gerontology, Aging, Longitudinal study, medicine.medical_specialty, Frail Elderly, Nutritional Status, Context (language use), Motor Activity, Article, Risk Factors, Cause of Death, Internal medicine, Activities of Daily Living, Linear regression, medicine, Humans, Disabled Persons, Muscle Strength, Prospective Studies, Prospective cohort study, Survival rate, Cause of death, Aged, 80 and over, invecchiamento, business.industry, Settore MED/09 - MEDICINA INTERNA, Hazard ratio, General Medicine, Prognosis, Survival Rate, Zinc, Italy, Biomarker (medicine), Female, Geriatrics and Gerontology, business, Biomarkers, Copper, Fragilità, Follow-Up Studies
Abstract

Associations between copper to zinc ratio (CZr) and mortality have suggested CZr as a biomarker of aging. Nevertheless, very limited data exist on the association between serum CZr and physical or functional status of very old people. We examined the relationship between serum CZr and physical performance, muscle strength, functional status, and survival from the ilSIRENTE Study: a longitudinal study of persons aged 80 years or older (n = 346). An adjusted linear regression model was subsequently performed to calculate the regression coefficients of the associations between baseline physical and functional measures (dependent variable) with CZr or “Cu and Zn” alone taking also into account the influence of other relevant factors, including hematological (albumin, cholesterol, and urea) and inflammatory biomarkers (IL-6 and CRP) that were significantly different across CZr tertiles. CZr showed significant and stronger relationships than Cu or Zn alone with all baseline physical and functional measures in models that did not include adjustments for inflammatory parameters. CZr was also associated with physical decline, measured as “SPPB% decline” at 2 years of follow-up and mortality at 4 years of follow-up. Subjects in the high CZr tertile had a higher risk of death with an adjusted hazard ratio of 1.92 (95% CI, 1.12–3.29; p = 0.02). In conclusion, we have confirmed the role of CZr as a predictor of mortality, whereas the role of CZr as a biomarker or predictor of physical or functional performance seems to be the consequence of its strict relationships with inflammatory parameters. In this context, further investigations need to be carried out.

Published
2011

24. Improving the prognostic value of multimorbidity through the integration of selected biomarkers to the comprehensive geriatric assessment: An observational retrospective monocentric study.

Author

Piacenza F, Di Rosa M, Fedecostante M, Madotto F, Montesanto A, Corsonello A, Cherubini A, Provinciali M, Soraci L, Lisa R, Bustacchini S, Bonfigli AR, and Lattanzio F

Abstract

Background: Multimorbidity (MM) burdens individuals and healthcare systems, since it increases polypharmacy, dependency, hospital admissions, healthcare costs, and mortality. Several attempts have been made to determine an operational definition of MM and to quantify its severity. However, the lack of knowledge regarding its pathophysiology prevented the estimation of its severity in terms of outcomes. Polypharmacy and functional impairment are associated with MM. However, it is unclear how inappropriate drug decision-making could affect both conditions. In this context, promising circulating biomarkers and DNA methylation tools have been proposed as potential mortality predictors for multiple age-related diseases. We hypothesize that a comprehensive characterization of patients with MM that includes the measure of epigenetic and selected circulating biomarkers in the medical history, in addition to the functional capacity, could improve the prognosis of their long-term mortality., Methods: This monocentric retrospective observational study was conducted as part of a project funded by the Italian Ministry of Health titled "imProving the pROgnostic value of MultimOrbidity through the inTegration of selected biomarkErs to the comprehensive geRiatric Assessment (PROMOTERA)." This study will examine the methylation levels of thousands of CpG sites and the levels of selected circulating biomarkers in the blood and plasma samples of older hospitalized patients with MM ( n = 1,070, age ≥ 65 years) recruited by the Reportage Project between 2011 and 2019. Multiple statistical approaches will be utilized to integrate newly measured biomarkers into clinical, demographic, and functional data, thus improving the prediction of mortality for up to 10 years., Discussion: This study's results are expected to: (i) identify the clinical, biological, demographic, and functional factors associated with distinct patterns of MM; (ii) improve the prognostic accuracy of MM patterns in relation to death, hospitalization-related outcomes, and onset of new comorbidities; (iii) define the epigenetic signatures of MM; (iv) construct multidimensional algorithms to predict negative health outcomes in both the overall population and specific disease and functional patterns; and (v) expand our understanding of the mechanisms underlying the pathophysiology of MM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Piacenza, Di Rosa, Fedecostante, Madotto, Montesanto, Corsonello, Cherubini, Provinciali, Soraci, Lisa, Bustacchini, Bonfigli and Lattanzio.)

Published
2022
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25. Design and methodology of the screening for CKD among older patients across Europe (SCOPE) study: a multicenter cohort observational study.

Author

Corsonello A, Tap L, Roller-Wirnsberger R, Wirnsberger G, Zoccali C, Kostka T, Guligowska A, Mattace-Raso F, Gil P, Fuentes LG, Meltzer I, Yehoshua I, Formiga-Perez F, Moreno-González R, Weingart C, Freiberger E, Ärnlöv J, Carlsson AC, Bustacchini S, and Lattanzio F

Subjects
Aged, Albuminuria, Biomarkers blood, Biomarkers urine, Clinical Protocols, Creatinine blood, Creatinine urine, Europe epidemiology, Glomerular Filtration Rate, Humans, Prospective Studies, Renal Insufficiency, Chronic epidemiology, Geriatric Assessment, Mass Screening, Renal Insufficiency, Chronic diagnosis
Abstract

Background: Decline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align laboratory and biomarker results with medical and functional data obtained from this cohort. The study was registered at ClinicalTrials.gov, identifier NCT02691546, February 25th 2016., Methods/design: An observational, multinational, multicenter, prospective cohort study in community dwelling persons aged 75 years and over, visiting the outpatient clinics of participating institutions. The study will enroll 2450 participants and is carried out in Austria, Germany, Israel, Italy, the Netherlands, Poland and Spain. Participants will undergo clinical and laboratory evaluations at baseline and after 12 and 24 months- follow-up. Clinical evaluation also includes a comprehensive geriatric assessment (CGA). Local laboratory will be used for 'basic' parameters (including serum creatinine and albumin-to-creatinine ratio), whereas biomarker assessment will be conducted centrally. An intermediate telephone follow-up will be carried out at 6 and 18 months., Discussion: Combining the use of CGA and the investigation of novel and existing independent biomarkers within the SCOPE study will help to provide evidence in the development of European guidelines and recommendations in the screening and management of CKD in older people., Trial Registration: This study was registered prospectively on the 25th February 2016 at clinicaltrials.gov ( NCT02691546 ).

Published
2018
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26. Cu to Zn ratio, physical function, disability, and mortality risk in older elderly (ilSIRENTE study).

Author

Mocchegiani E, Malavolta M, Lattanzio F, Piacenza F, Basso A, Abbatecola AM, Russo A, Giovannini S, Capoluongo E, Bustacchini S, Guffanti EE, Bernabei R, and Landi F

Subjects
Aged, 80 and over, Biomarkers blood, Cause of Death trends, Female, Follow-Up Studies, Frail Elderly statistics & numerical data, Humans, Italy epidemiology, Male, Muscle Strength, Prognosis, Prospective Studies, Risk Factors, Survival Rate trends, Activities of Daily Living, Aging physiology, Copper blood, Disabled Persons, Motor Activity physiology, Nutritional Status, Zinc blood
Abstract

Associations between copper to zinc ratio (CZr) and mortality have suggested CZr as a biomarker of aging. Nevertheless, very limited data exist on the association between serum CZr and physical or functional status of very old people. We examined the relationship between serum CZr and physical performance, muscle strength, functional status, and survival from the ilSIRENTE Study: a longitudinal study of persons aged 80 years or older (n = 346). An adjusted linear regression model was subsequently performed to calculate the regression coefficients of the associations between baseline physical and functional measures (dependent variable) with CZr or "Cu and Zn" alone taking also into account the influence of other relevant factors, including hematological (albumin, cholesterol, and urea) and inflammatory biomarkers (IL-6 and CRP) that were significantly different across CZr tertiles. CZr showed significant and stronger relationships than Cu or Zn alone with all baseline physical and functional measures in models that did not include adjustments for inflammatory parameters. CZr was also associated with physical decline, measured as "SPPB% decline" at 2 years of follow-up and mortality at 4 years of follow-up. Subjects in the high CZr tertile had a higher risk of death with an adjusted hazard ratio of 1.92 (95% CI, 1.12-3.29; p = 0.02). In conclusion, we have confirmed the role of CZr as a predictor of mortality, whereas the role of CZr as a biomarker or predictor of physical or functional performance seems to be the consequence of its strict relationships with inflammatory parameters. In this context, further investigations need to be carried out.

Published
2012
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